Investigating patient characteristics on pain assessment using virtual human technology

Pain assessment and treatment is challenging and can be influenced by patient demographic characteristics. Few research studies have been able to specifically examine these influences experimentally. The present study investigated the effects of patients’ sex, race, age, and pain expression on healthcare students’ assessment of pain and pain‐related sequelae using virtual human (VH) technology. A lens model design was employed, which is an analogue method for capturing how individuals use environmental information to make judgments. In this study, decision‐making policies were captured at the nomothetic and idiographic level. Participants included 107 healthcare students who viewed 32 VH patients that differed in sex, race, age, and pain expression in an online study. Participants provided ratings on a 100‐point scale on the VH pain intensity, pain unpleasantness, negative mood, coping, and need for medical treatment. Nomothetic analyses revealed that female, African–American, older, and high pain expression VH were rated higher than male, Caucasian, younger, and low pain expression VH, respectively, on most of the five ratings. Idiographic analyses revealed detailed findings for individuals’ decision‐making policies. VH technology and the lens model design were shown to be highly effective in examining individuals’ decision‐making policies. Pain assessment often varied among individuals based on patient demographic and facial expression cues. This study could serve as a model for future investigations of pain assessment and treatment in healthcare students and providers.

[1]  R. Fillingim,et al.  Ethnic differences in responses to multiple experimental pain stimuli , 2005, Pain.

[2]  Steven Z. George,et al.  Pain assessment and treatment disparities: A virtual human technology investigation , 2009, Pain.

[3]  Ray W. Cooksey,et al.  Judgment analysis : theory, methods, and applications , 1996 .

[4]  Joshua Chodosh,et al.  The Quality of Medical Care Provided to Vulnerable Older Patients with Chronic Pain , 2004, Journal of the American Geriatrics Society.

[5]  K. Craig,et al.  A comparison of two measures of facial activity during pain in the newborn child. , 1994, Journal of pediatric psychology.

[6]  R. Lipton,et al.  Variation in migraine prevalence by race , 1996, Neurology.

[7]  R. Fillingim,et al.  The relationship of sex and clinical pain to experimental pain responses , 1999, PAIN®.

[8]  K R Hammond,et al.  How Convergence of Research Paradigms Can Improve Research on Diagnostic Judgment , 1996, Medical decision making : an international journal of the Society for Medical Decision Making.

[9]  G H Smith,et al.  Assessment of Pain , 2011 .

[10]  A. J. Fridlund Human Facial Expression: An Evolutionary View , 1994 .

[11]  G. A. Miller THE PSYCHOLOGICAL REVIEW THE MAGICAL NUMBER SEVEN, PLUS OR MINUS TWO: SOME LIMITS ON OUR CAPACITY FOR PROCESSING INFORMATION 1 , 1956 .

[12]  M. Grace,et al.  Environment, Anxiety, and Postoperative Pain , 1990, Western journal of nursing research.

[13]  S. Lai,et al.  Patients' perceptions of overall function, pain, and appearance after primary posterior instrumentation and fusion for idiopathic scoliosis. , 1999, Spine.

[14]  P. Ekman,et al.  Facial action coding system: a technique for the measurement of facial movement , 1978 .

[15]  M. Cousins International association for the study of pain , 1989, Pain.

[16]  R. Fillingim,et al.  Race, ethnicity and pain , 2001, PAIN.

[17]  P. Windyga,et al.  Is there a Primal Face of Pain? A methodology answer , 2007, 2007 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[18]  A. Williams Handbook of pain assessment , 1995 .

[19]  Howard L. Fields,et al.  Core Curriculum for Professional Education in Pain , 1992 .

[20]  A. Dekker,et al.  Healthcare Disparities in Pain Management , 2005, The Journal of the American Osteopathic Association.

[21]  W. Stein Pain in the nursing home. , 2001, Clinics in geriatric medicine.

[22]  A. Horgas,et al.  Pain assessment and management in persons with dementia. , 2004, The Nursing clinics of North America.

[23]  Don Beal,et al.  The Lens Model: Computational Procedures and Applications , 1978 .

[24]  R. Helme,et al.  The epidemiology of pain in elderly people. , 2001, Clinics in geriatric medicine.

[25]  H. Thaler,et al.  Pain in ambulatory AIDS patients. I: Pain characteristics and medical correlates , 1996, Pain.

[26]  M. Meltzer,et al.  Glaucoma's impact on quality of life and its relation to clinical indicators. A pilot study. , 1998, Ophthalmology (Rochester, Minn.).

[27]  M. Robinson,et al.  Virtual human technology: Capturing sex, race, and age influences in individual pain decision policies , 2008, PAIN.

[28]  R. Fillingim,et al.  Influences of gender role and anxiety on sex differences in temporal summation of pain. , 2004, The journal of pain : official journal of the American Pain Society.